721 2013 721 VA Questionnaire 11-26-12

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Overview

Current Model Qsts
Current Custom Qsts

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Sheet 1: Current Model Qsts

Model Instance Name: VA
MID:	Qp5RQMEAMhZsgoRFNM1Exg==
Date:	7/18/2008
MODEL QUESTION LIST
Model questions utilize the ACSI methodology to determine scores and impacts
	ELEMENTS (drivers of satisfaction)		CUSTOMER SATISFACTION		FUTURE BEHAVIORS
	Content (1=Poor, 10=Excellent, Don't Know)		Satisfaction (1=Poor, 10=Excellent)		Likelihood to Return (1=Not Very Likely, 10=Very Likely)
1	Please rate the accuracy of information on this site.	23	What is your overall satisfaction with this site?	26	How likely are you to return to this site?
2	Please rate the quality of information on this site.	24	How well does this site meet your expectations?		Recommend (1=Not Very Likely, 10=Very Likely)
3	Please rate the freshness of content on this site.	25	How does this site compare to your idea of an ideal website?	27	How likely are you to recommend this site to someone else?
	Functionality (1=Poor, 10=Excellent, Don't Know)
4	Please rate the usefulness of the services provided on this site.
5	Please rate the convenience of the services on this site.
6	Please rate the ability to accomplish what you wanted to on this site.
	Look and Feel (1=Poor, 10=Excellent, Don't Know)
7	Please rate the ease of reading this site.
8	Please rate the clarity of site organization.
9	Please rate the clean layout of this site.
	Navigation (1=Poor, 10=Excellent, Don't Know)
10	Please rate the degree to which the number of steps to get where you want is acceptable.
11	Please rate the ability to find information you want on this site.
12	Please rate the clarity of site map/directory.
13	Please rate the ease of navigation on this site.
	Search (1=Poor, 10=Excellent, Don't Know)
14	Please rate the usefulness of search results on this site.
15	Please rate how this site provides comprehensive search results.
16	Please rate the organization of search results on this site.
17	Please rate how the search feature helps you to narrow the results to find the information you want.
	Site Performance (1=Poor, 10=Excellent, Don't Know)
18	Please rate the speed of loading the page on this site.
19	Please rate the consistency of speed on this site.
20	Please rate the reliability of site performance on this site.

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Sheet 2: Current Custom Qsts

Model Instance Name: VA			red & strike-through: DELETE
			underlined & italicized: RE-ORDER
MID: Qp5RQMEAMhZsgoRFNM1Exg==			pink: ADDITION
Date:	6/8/2009		blue + -->: REWORDING
			violet (bold): SKIP-LOGIC
CUSTOM QUESTION LIST
QID	Skip Logic Label	Question Text	Answer Choices (limited to 50 characters)	Skip to	Type (select from list)	Single or Multi	Required Y/N	Special Instructions	CQ Label
ACQhar0019537		How often do you visit the Veterans Administration website (www.va.gov)?	First time		Radio Button One Up Vertical	Single	Y	Skip Logic	Visit Frequency
			More than once a day	A, B
			Daily	A,B
			About once a week	A,B
			About once a month	A,B
			Every 6 months or less	A,B
ACQhar0019538	A	Please select the statement which best describes your experience with the new Veterans Administration (www.va.gov)  homepage redesign:	It is easier to find what I am looking for		Radio Button One Up Vertical	Single	Y	Skip Logic	redesign ability to find
			It is harder to find what I am looking for
			My experience is no different when looking for information on the new site
			Don't Know
ACQhar0019539	B	Do you like the new layout of the homepage?	Yes		Radio Button One Up Vertical				Opinion of Redesign
			No	BB
			No opinion
ACQhar0019540	BB	What didn't you like about the new homepage?			Text Area – no character limit		N	Skip Logic	OE_Dislike redesign
ALM0002		Please tell us who you are. (Check all that apply)	Veteran		Check-boxes	Multi	Y
			Active duty
			Dependent or beneficiary of a veteran
			VA employee
			Volunteer
			Other	A
AED01259	A	Other Please Specify: Please tell us who you are.			Open-ended	Single	N
AED01261		Please check the conflict(s) in which you served.	World War II		Check-boxes	Multi	N
			Korean Conflict
			Vietnam Era
			Persian Gulf War
			Operation Enduring Freedom
			Operation Iraqi Freedom
			No conflict/war service
ALM0041		Please select your age range.	17 or under		Radio Button Two Up Vertical	Single	N
			18-24
			25-34
			35-44
			45-54
			55-64
			65+
AED01262		Please select your gender:	Male		Radio Button Two Up Vertical	Single	N
			Female
AKR1685		In which state do you reside?	Alabama		Dropdown (Select-one)	Single	N
			Alaska
			Arizona
			Arkansas
			California
			Colorado
			Connecticut
			Delaware
			District of Columbia
			Florida
			Georgia
			Hawaii
			Idaho
			Illinois
			Indiana
			Iowa
			Kansas
			Kentucky
			Louisiana
			Maine
			Maryland
			Massachusetts
			Michigan
			Minnesota
			Mississippi
			Missouri
			Montana
			Nebraska
			Nevada
			New Hampshire
			New Jersey
			New Mexico
			New York
			North Carolina
			North Dakota
			Ohio
			Oklahoma
			Oregon
			Pennsylvania
			Rhode Island
			South Carolina
			South Dakota
			Tennessee
			Texas
			Utah
			Vermont
			Virginia
			Washington
			West Virginia
			Wisconsin
			Wyoming
			Canada
			I live elsewhere
AED02830		What information were you primarily looking for today?	Jobs	B	Dropdown (Select-one)	Single	Y
			VA disability payment	D
			Medical center information	F
			Health care program information
			Health care
			Home loans
			Burial services and benefits
			General health information
			Family and dependent benefits
			Benefits regional offices information
			Hospital/clinic locations
			Health care eligibility
			Healthcare education
			Other, please specify	A
AED02831	A	Other, please specify: What information were you primarily looking for today?			Open-ended	Single	N
AED02836	B	What type of job information were you looking for?	Job listings		Dropdown (Select-one)	Single	Y
			Job training
			Vocational Rehabilitation
			Hiring Veterans
			Small Business Development
			Vocational Counseling
			Other, please specify	C
AED02837	C	Please specify what type of job information you were looking for			Open-ended	Single	N
AED02834	D	What type of VA disability payment information were you looking for?	Personal disability payment information		Dropdown (Select-one)	Single	Y
			Claim status Rating decision
			Other, please specify	E
AED02835	E	Please specify what type of VA disability payment information you were looking for			Open-ended	Single	N
AED02832	F	What type of Medical Center information were you looking for?	Facility contact information		Dropdown (Select-one)	Single	Y
			Directions
			Hours of operation
			Services available
			Make, change, or cancel an appointment
			Prescription refill
			Other, please specify	G
AED02833	G	Please specify what type of Medical Center information were you looking for			Open-ended	Single	N
ACQhar0019541		Did you find what you were looking for today?	Yes		Radio Button One Up Vertical	Single	Yes		Task Accomplishment
			No	A
ACQhar0019542	A	Please explain why you were unable to find what you were looking for today?			Text Area – no character limit		N		OE_Unable to find
AKR2273		Please indicate on which social media outlets you have seen a VA presence (i.e. materials or links).  Select all that apply.	I don’t visit social media outlets		Checkbox One Up Vertical	Multi	Y
(AKR2273G1)			I have not seen a VA presence on any social media outlets
			Blogs
			Facebook
			MySpace
			Second Life
			Twitter
			YouTube
			Other, please specify	A
AKR2274	A	Other social media outlet			Open-ended	Single	N
AKR2349		Do you read blogs?	Yes	A	Radio Button One Up Vertical	Single	Y
(AKR2349G5)			No
AKR2350	A	Have you ever commented on a blog?	Yes		Radio Button One Up Vertical	Single	N
			No
AKR2351		Have you ever uploaded a video to the Internet?	Yes		Radio Button One Up Vertical	Single	Y
			No
AKR2352		Do you subscribe to RSS feeds?	Yes		Radio Button One Up Vertical	Single	Y
			No
AKR2353		Do you use any of these Social Networks (check all that apply):	Do not have a Social Network page		Checkbox One Up Vertical	Multi	Y
(AKR2353G1)			Facebook
			MySpace
			LinkedIn
			Twitter
			Other, please specify	A
AKR2354	A	Other, please specify			Text Area – no character limit	Single	N
ACQLiv0017839		Do you ever access the Internet using a mobile phone or tablet?	Yes	A, B	Radio button, one-up vertical	Single	Y	Access Mobile Internet
			No
ACQLiv0017840	A	Which of the following devices do you have?	A SmartPhone	W	Checkbox One Up Vertical	Multi	Y	Phone or Tablet
			A tablet	X
			None of these
ACQLiv0017841	W	Specifically, which type of mobile phone do you have?	iPhone		Radio button, one-up vertical	Single	Y	Phone Type
			Android
			Blackberry
			Another phone
ACQLiv0017842	X	Specifically, which type of tablet do you have?	iPad		Radio button, one-up vertical	Single	Y	Tablet Type
			Kindle
			Android
			Blackberry
			Another tablet
ACQLiv0017843	B	Have you ever accessed ANY federal website using a mobile phone or tablet?	Yes	C	Radio button, one-up vertical	Single	Y	Federal Mobile Site Usage
			No, but I plan to do so
			No, but I might in the future
			No, and I don't plan to do so
ACQLiv0017844	C	Have you ever accessed The Department of Veteran's Affairs site (VA.gov) using a mobile phone or tablet?	Yes	Y, Z	Radio button, one-up vertical	Single	Y	Mobile Site Usage
			No, but I plan to do so	Z
			No, but I might in the future	Z
			No, and I don't plan to do so
ACQLiv0017845	Y	What was the main reason you last visited VA.gov using a mobile phone or tablet?			Text area, no char limit	Single	N	Mobile Primary Reason
ACQLiv0017846	Z	What additional resources might you want to access from VA.gov using a mobile phone or tablet?			Text area, no char limit	Single	N	MobileDesired Resources